AUTOMOBILE ACCIDENTS, SLIP AND FALL ACCIDENTS, PERSONAL INJURY CLAIMS – WHY IT TAKES TIME TO SETTLE THESE CLAIMS

Personal injury claims consist of many different types of claims. Those claims included automobile accidents; car crashes; motorcycle accidents, slip and fall accidents, trip and fall accidents, defective products, medical malpractice and many other types and kinds of accidents.

Ford_E-Series_Ambulance

Personal Injury Involving Ambulance Service

Generally, medical malpractice, elder abuse, defective drugs, train crashes and airplane crashes are handled differently then general personal injury claims. Personal injury claims such as automobile accidents; car crashes; motorcycle accidents, slip and fall accidents, trip and fall accidents and general liability claims I have found common factors in the claims handling process.

Often clients feel it “takes too long” to get their cases settled and sometimes feel that the “offers are too low.” First you should know that no two claims are the same. Claims like people are individual and unique.

Why it often takes a long time to settle many personal injury claims, such as automobile accidents; car crashes; motorcycle accidents, slip and fall accidents, trip and fall accidents and general liability claims, is because the claims settlement process requires considerable documentation. An insurance company rarely if ever accepts an attorney’s representations without supporting documentation. Often the smaller the claim, the more difficult it is to settle, particularly when it comes to the “pain and suffering” aspects of the claim. As well, contested liability claims are very difficult to settle the insurance carrier takes the position “our insured did nothing wrong.”

When it comes to claims handling it is constantly entertaining to see how different companies choose individuals to manage its finances: in banks, the lowest paid staff members are usually tellers and count the cash; in a storehouse, the shipping clerk sends out and receives everything owned by the company; and in most accounting departments, a clerk prepares and issue checks giving only the most brief review of the invoice before mailing. Well, the truth is that insurance companies handle personal injury claims including automobile accidents; car crashes; motorcycle accidents, slip and fall accidents, trip and fall accidents and general liability claims about the same way.

My experience has shown that the individual originally assigned to your case will not likely be the adjuster, who will ultimately be responsible for settling your claim. Often they assign a claim to an adjuster or clerk with little experience. In that last few years I have noticed a change with some personal injury insurance carriers and they assign your claim to a “team.” Unfortunately often the “team” has little experience. In any event, the first step in opening a personal injury claim requires the setting of an initial reserve. This requires assigning a value based upon the apparent seriousness of the loss, such as broken bones versus soft tissue only. Unless injuries are serious and self evident, initial claim evaluations made by the insurance company will be unrealistically low, which can lead to a problem settling your case down the road. We try to give the insurance company as much information known to us at the time of the incident but often the extent of personal injuries and other losses are unknown.

The days when these types of personal injury claims, such as automobile accidents; car crashes; motorcycle accidents, slip and fall accidents, trip and fall accidents and general liability claims. ln would be initially reviewed by a claims supervisor no longer exists. Years ago it would be usual for a claims supervisor to review a claim and designate an adjuster with the experience and ability to handle the claim to its conclusion efficiently.

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Auttomobile Accidents Between Bues and Cars Are Common and Often Cause Personal Injuries to Drivers and Passengers*

Today with computer programs such Colossus and team approaches I have found that are still “levels of claims” adjuster. An assignment of claim should be based upon the complexity of the claim and seriousness of the injuries, however, often they base claim assignment exclusively on the expected value of the claim, i.e., the reserve the insurance company has set on the claim. By way of example, perceived small claims involving $5,000 or less may all be assigned to a very inexperienced claims handler, and we will call him Bill. But claims that say fall into the $5, 000 to $20,000 range may be assigned to a more experience claims adjuster. claims would be designated to James and more senior claims handler Susan would take the $20,000 to $75,000 claims and a supervisor would take all the claims anticipated to exceed $75,000 in settlement value. These “assignments” are done at the time the claim is initially submitted.

So what happens when your more than $20,000 claim gets assigned to “wrong level?”The fact that they have assigned your claim to an adjuster without sufficient authority does not mean that the adjustor is incompetent or that her supervisor does not respect her/his opinions. Therefore, attorneys need to work with the adjuster to enable them to evaluate your claim properly. Frequently cases / claims get reassigned to a different adjuster. The “new” adjuster now has to get up to speed on your claim.

Keep in mind that many adjusters have caseloads of more than a 125 files often higher, much higher. In order to settle a case, the adjuster needs “documentation.” This includes medical documentation for injuries, documentation for medical expenses, documentation for loss of income. Depending upon whom you have seen for medical care obtaining medical reports and medical records can be very difficult to get because the doctor’s office does not cooperate. I have had cases in which we wait months and months to get such documentation. The same is true for loss of income or for self-employed individuals who cannot provide documentation regarding loss of income. The insurance companies will not accept and pay claims that are not properly documented. All of this takes time. Sometimes clients are unhappy with the delays.

My experience has shown in personal injury cases, involving claims such as automobile accidents, car crashes, motorcycle accidents, slip and fall accidents, trip and fall accidents and general liability accidents, it is common for insurance adjusters to begin negotiations by making a very low first offer. Sometimes, the adjuster will deny all liability for the claim. These negotiation tactics often work because some personal injury attorneys out there accept the first or second lowball offer. Because we must tell clients of all offers, an impatient attorney or client to get, some money will take any amount, I think this is a mistake.

I have had personal injury claims in my office for more than a year but over weeks and months the offers increase often dramatically. I recently settled a personal injury automobile accident claim for $27,500.00, and the original offer on the case was $7,000.00. This case took almost 18 months to settle and the client was very anxious to have his case settled. This case has been through three different adjusters. At one point the client was willing to accept a far lower offer to “get it over.” I told him that it was not a good idea and please follow my advice. He did and we settled his case fairly.

However, as a claimant you need to keep in mind that as a lawyer we need to work with the adjusters to settle a claim. Some of your reading this may believe that “if only my case got in front of jury” they would award me a lot of money. YOU ARE WRONG. On some cases, particularly smaller “fender bender” cases, resorting to litigation / filing a lawsuit is often losing proposition FOR YOU.

The fact is that personal injury claims such as involving claims such as automobile accidents, car crashes, motorcycle accidents, slip and fall accidents, trip and fall accidents and general liability accidents (Tort cases, as they are called) have been on the decline for decades. According to the National Center for State Courts (NCSC), tort cases declined by 25 percent between 1999 and 2008 and are still on the decline. The belief that juries or judges award large amounts is wrong. The fact is that most lawsuits result in comparatively small verdicts.

Lawsuits are very expensive. No law firm can afford to accept weak or frivolous cases. In California I have found that jurors are usually fairly smart, not easily fooled and are not very sympathetic with soft tissue personal injury claims. It takes the average lawyer and law firm between 100-500 hours of time and thousands of dollars in court costs to prepare for a trial. The entire process often takes between 2 and 5 years – even a simple fender-bender case. The expense for even a simple jury trial begins at around $15,000.00. Unless your case is in limited jurisdiction you need live expert testimony concerning medical care, treatment and charges. If you have seen several physicians, chiropractors or other healthcare providers, most or all need to be called at the time of trial. Expert fees even for treating physicians, chiropractors or other healthcare providers can run into thousands of dollars.

Current studies show that personal injury claims involving back and neck strains in California have a median verdict of $10,885 ! ! ! So a jury trial can cost more than you are likely to recover. Now some of you may be thinking that does not happen often, YES IT DOES. Here are some examples:

2012 Corbin v. Pascarella $10,400 Verdict. The defendant hits plaintiffs’ vehicle in an intersection. Plaintiff’s 13-year-old daughter claimed lower back, necks, and shoulder pain because of the collision. Plaintiff (mother) settles her claim before trial. A Los Angeles County jury awards $10,400 to the daughter

2012 Messina v. Bayne $11,430 Verdict. Plaintiff is stopped with traffic when his vehicle is hit from behind. Initially plaintiff only took one day off and returned to his work at a supermarket. Shortly after the incident he sees a chiropractor for four visits. Plaintiff claims a “10 out of 10” on the pain scale. He changes chiropractors and gets additional treatment and he later takes an additional 11 days off of work. He receives physical therapy for about 8 months from February 2010 to November 2010. Defendant / Farmers Insurance Company contests the need for the “second” chiropractor visits and treatments. Defendant / Farmers Insurance Company denies that the plaintiff’s claim for lost wages beyond the first day were unreasonable. The jury award likely shows what the jury thought of the claim. .

2013 – Reveles v. O’Neal $5,000 Verdict. Defendant driver crossed double yellow line and collided into oncoming car. The plaintiff suffered injuries. Plaintiff had medical bills of about $70,000, but the medical expenses were not allowed to go to the jury because a medical expert was not called. The injuries appeared to be mainly soft tissue. A San Diego County jury awarded $5,000, which is paid by defendant’s insurance, Commerce West Group.

THE TAKE AWAY?

Be patient, and patience is a truly a virtue in settlement negotiations. Although you may “need” the money now, it is rarely to your advantage to “hurry through the process.” Allow your attorney to their job. Most attorney’s will give you good advice on these types of claims.

Believe me, claims adjusters are pretty good at sensing anxiety. If your attorney shows anxiousness, the adjuster will likely change her/his focus away from the settlement, and on the sense of desperation. The adjuster will likely then base further settlement discussions on that sense of anxiety, rather than the facts of the claim.

Does the adjuster have to treat you / your claim fairly? The simple answer is no. Under California law on third party claims, law does not bind the adjuster to treat you fairly. California does not recognize third party bad faith claims.

My advice is simple, stay calm. If you have trust and faith in your attorney allow him or her to do their job. If you do not have confidence in your attorney, well that is another story for another day.

In the event you have suffered or a loved one has suffered a personal injury from any type of incident (automobile accidents; car crashes; motorcycle accidents, slip and fall accidents, trip and fall accidents, defective products, medical malpractice and many other types and kinds of accidents) you should contact a personal injury attorney.

Richard M. Katz, Esq., is a Pasadena personal injury lawyer. We handle personal injury claims we specialize in accident, medical malpractice and Kaiser Permanente malpractice claims.

I am here to answer your questions and give you help. For a free consultation, please feel free to give me a call. 626-796-6333. My office is located at 1122 East Green Street, Pasadena, California, 91106

*The Bus New Flyer Accident, public domain, by Daniel Ramirez

 

Do I Have A Case? Premises Liability

Who is responsible for accidents that occur on or around buildings and grounds?

We often refer to personal injury accidents that are caused by a defective condition or a dangerous condition on property, either outside, such as a sidewalk or parking lot or inside a building, as “premises liability” accidents. These premises liability accidents can occur at commercial buildings (stores or offices), commercial venues (amusement parks or water parks) residences (private homes or rentals), or on public property (parks, streets, or public transportation facilities).

Many circumstances can cause a dangerous condition on premises, such as — unsafe design, poor construction or poor building materials, improper maintenance, improperly managed amusement rides. Dangerous conditions on premises can lead to many types of personal injury accidents including slip and fall, trip and fall, being hit by an item falling on you or any number of ways.

It may surprise you to learn that in order to recover for personal injuries suffered on another’s property you must prove that they were negligent in the use and management of their property. Sometimes the property owner / possessor of property is responsible and sometimes not. Premises liability personal injury claims are very dependent on the facts and circumstances surrounding the incident.

Generally the owner or possessor of a property has a duty to anyone who enters the property not to expose that individual an unreasonable risk of harm because of condition, construction or design of the property. The logic for the rule is understandable: The owner or possessor of the premises has complete control over of the premises and is in the best position to maintain and control the premises. A visitor at someone else’s property has a right to assume the property is in a reasonable safe condition for its intended use and purpose.

Nevertheless, a visitor must use the property properly. This can be somewhat moderated depending upon the age of the visitor. However, as a rule the conduct of the injured person can be an issue. By way of example, if a person gets injured while acting in an unexpected, unauthorized, or dangerously careless way, the property owner or occupier will probably not be responsible for the injury.

Under California law the owner (owner, possessor, renter, governmental entity) of a premise or location is not “automatically responsible” for the injuries suffered by a customer or a pedestrian. The California Supreme Court in Ortega v. Kmart (2001) 26 Cal.4th 1200 [114 Cal.Rptr.2d 470, 36 P.3d 11] set forth the law for slip and fall / trip and fall claims. Ortega involved a store in which a patron suffered an injury because of a slip and fall accident.

The Court stated that “It is well established in California that although a store owner is not an insurer of the safety of its patrons. (Ortega, supra, 26 Cal.4th at p. 1205.” The Court went on to state “Because the owner is not the insurer of the visitor’s personal safety, the owner’s actual or constructive knowledge of the dangerous condition is a key to establishing its liability.” (Ortega, supra, 26 Cal.4th at p. 1206). The Court further held that “Courts have also held that where the plaintiff relies on the failure to correct a dangerous condition to prove the owner’s negligence, the plaintiff has the burden of showing that the owner had notice of the defect in sufficient time to correct it.” (Ortega, supra, 26 Cal.4th at p. 1206.)

In the case of Getchell v. Rogers Jewelry (2012) 203 Cal.App.4th 381, 385 [136 Cal.Rptr.3d 641], the Court held that “Generally speaking, a property owner must have actual or constructive knowledge of a dangerous condition before liability will be imposed. In the ordinary slip and fall case, . . . the cause of the dangerous condition is not necessarily linked to an employee. . .”

If you have been injured because of a premises accident at a commercial building (store or office), or at a commercial venue (amusement park or water park), or at a residence (private home or rental), or on public property (park, street, or public transportation facility), you may be thinking “Do I have a case?”

Consider this an owner / possessor of property will be found negligent in the use or maintenance of their property if 1) a condition on the property created an unreasonable risk of harm; 2) the owner / possessor knew or, through the exercise of reasonable care, should have known about the dangerous condition; and 3) the owner / possessor failed to repair the condition, protect against harm from the condition, or give adequate warning of the condition.

The Law Offices of Richard M. Katz has had many successful claims against property owners over the years we have had successful results against governmental entities, private homeowners, builders, amusement parks and venues. Some of these cases resulted in death and serious injury. If you or someone you know has been injured or killed possibly on someone else’s premises please give me a call for a free consultation. Please contact Richard M. Katz, Esq. at 626-796-6333 so that my office can help protect your legal rights.

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Sympathy Does Not Work at Trial! I Dare You to Watch “Le poids des apparences | The importance of appearances”

I always tell my clients sympathy does not work at trial. Although an initial reaction of a judge or jury may be sympathy, the sympathy does not last long. When is the last time you saw a “homeless person?” Perhaps initially you felt some sorrow or sympathy but did you give them money, food or even the time of day? A shocking video proves what I have learned in over 35 years of practice.

In a staged event by a French comic, who goes by the name Norni Tube (at least on Youtube) in a short clip, entitled ‘Le poids des apparences | The importance of appearances.’ The video shows two scenarios. In the first “experiment” an actor is shabbily dressed. His call for help are ignored by people walking by, you will actually see people looking over and “sneak” a look in his direction. Ultimately, the actor gets up and leaves. Later in the video, the same actor dressed as a business man, wearing a suit and tie again collapses at the same location, this time people come to assist almost immediately.

Norni Tube stated in his description of the video (translated from French) ” I’ve never been so sad and shocked while filming as I was for this experience.
I hope this video will make you want to help anyone. regardless of its appearance.”

 

 

Appearances

Please take the time to watch the ‘Le poids des apparences | The importance of appearances.’

Sympathy? What sympathy?

What would you have done?

 

 

UP TO 40 PERCENT OF ANNUAL DEATHS FROM EACH OF FIVE LEADING CAUSES ARE PREVENTABLE

According to the Centers for Disease Control and Prevention, each year, nearly 900,000 Americans die prematurely from the five leading causes of death . However, the Centers for Disease Control estimate that a large percentage of those deaths 20 percent to 40 percent from each cause could be prevented. The percentage varies greatly from state to state.

In the United States the five leading causes of death are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. Collectively they caused 63 percent of all U.S. deaths in 2010. Unintentional injuries include car accidents, slip and fall accidents and other personal injury accidents. The Institute of Medicine’s (IOM) seminal study of preventable medical errors estimated as many as 98,000 people die every year from medical negligence and is the sixth leading cause of death in the United States.

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The report, in a recent issue of the CDC’s weekly journal, Morbidity and Mortality Weekly Report, examined premature deaths (before age 80) from each cause for each state from 2008 to 2010. The authors then calculated the number of deaths from each cause that would have been prevented if all states had same death rate as the states with the lowest rates.

The study suggests that, if all states had the lowest death rate observed for each cause, it would be possible to prevent:

34 percent of premature deaths from heart diseases, prolonging about 92,000 lives
21 percent of premature cancer deaths, prolonging about 84,500 lives
39 percent of premature deaths from chronic lower respiratory diseases, prolonging about 29,000 lives
33 percent of premature stroke deaths, prolonging about 17,000 lives
39 percent of premature deaths from unintentional injuries, prolonging about 37,000 lives

 

Tom Frieden, MD, MPH was quoted in a CDC article as stating “As a doctor, it is heartbreaking to lose just one patient to a preventable disease or injury – and it is that much more poignant as the director of the nation’s public health agency to know that far more than a hundred thousand deaths each year are preventable,”. “With programs such as the CDC’s Million Hearts initiative, we are working hard to prevent many of these premature deaths.”

Not surprisingly, there are many modifiable risk factors that are largely responsible for each of the leading causes of death, the CDC cites :

Heart disease risks include tobacco use, high blood pressure, high cholesterol, type 2 diabetes, poor diet, overweight, and lack of physical activity.

Cancer risks include tobacco use, poor diet, lack of physical activity, overweight, sun exposure, certain hormones, alcohol, some viruses and bacteria, ionizing radiation, and certain chemicals and other substances.

Chronic respiratory disease risks include tobacco smoke, second-hand smoke exposure, other indoor air pollutants, outdoor air pollutants, allergens, and exposure to occupational agents.

Stroke risks include high blood pressure, high cholesterol, heart disease, diabetes, overweight, previous stroke, tobacco use, alcohol use, and lack of physical activity.

Unintentional injury risks include lack of seatbelt use, lack of motorcycle helmet use, unsafe consumer products, drug and alcohol use (including prescription drug misuse), exposure to occupational hazards, and unsafe home and community environments.

As you can see by making changes in personal behaviors many of the risks are avoidable. Others risk factors are attributable to disparate conditions in social, demographic, environmental, economic, and geographic attributes of the local areas in which people work and live.

The study authors note that if health disparities were eliminated, as called for in Healthy People 2020 all states would be closer to achieving the lowest possible death rates for the leading causes of death.

Harold W. Jaffe, MD, the study’s senior author and CDC’s associate director for science was quoted in the CDC article as saying “We think that this report can help states set goals for preventing premature death from the conditions that account for the majority of deaths in the United States,” He was further quoted as saying “Achieving these goals could prolong the lives of tens of thousands of Americans.”

One can learn from these findings and change their and their family’s lifestyle for a healthier life.

WHY HIRE A PERSONAL INJURY ATTORNEY? YOU WOULD NOT OPERATE ON YOURSELF, WOULD YOU?

Trying to decide whether to hire a personal injury attorney / personal injury lawyer?

There are many types of personal injury claims. Claims can arise from car accidents, slip and fall accidents, dangerous premise conditions, workplace accidents (even if you have a worker’s compensation claim, you may have a “third party claim”), airplane, bus and train crashes, construction accidents, fires, food poisoning, drug or vitamin overdoses, animal bites, criminal acts and assaults and medical malpractice to name several.

You have been involved in an incident and suffered personal injuries and are trying to decide whether to hire an attorney. Well, it is probably a good idea to consult with a personal injury who has familiarity with your type of claim. The consultations are usually free.

He or she will review the facts of your matter. Generally an attorney will initially look at three issues. They are, was the other party negligent? What are the nature and extent of damages? Is there a relationship between the incident and the claimed injuries. After this analysis an attorney can make an assessment of the relative strengths or weaknesses of a claim and whether the claim had merit.

If an attorney concludes that the facts do not show someone was negligent, even if you suffered injuries, there is no case. In other words, you would have trouble making a case against an owner of a store if you spilled water or salad oil on the ground and then slipped and fell because of the spill. However, if the store owner had failed to fix the plumbing in the building and the water was on the floor because of leaky plumbing or one the store’s employees had spilled salad oil and nothing was done promptly to address the condition, then you possibly have a viable claim.

Many variables can come into play in determining negligence and often you may think that there was no negligence by anyone when there actually was.

I myself, have handled cases over the years in which folks did not think they had a case. However, they had suffered serious injuries, and they decided to contact me. After hearing the facts, I thought that there might be a viable claim. Following an investigation and research and believing the cases had merit, we have pursued an action. I will not go into the cases, but suffice it to say, we went to obtain a recovery for our clients. I might add that we took the cases on contingency basis and advanced all costs.

The point is if you have been injured, you should seek the advice of a competent personal injury attorney even if you do not think that there is anyone at fault. Only a good experienced personal injury attorney can evaluate your potential claim We are here to help, give me a call.
Richard M. Katz, 626-796-6333 or visit our website

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